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ELECTRICAL PERM�T APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - PAX 425-25?-8857 - wwv,�.everelhva.or9 �_��-a� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C 07 D b`�� � <br />�-> �� �,1. �) .. � � 'r y � �% � �' Cl�l/�; , <br />PROJECT ADDRESS <br />� _'- -7 ,• <br />-- , �' , <br />,� ; /,� i r /'<r h ��I ���c' / j <� t- -- i:'_ , =- � <br />01�mci _ —.___ 1,1.�i1 Address ��� G:� � _. � <br />Tenan� _ — __—_. 1.i.idi�,;..!;i., <br />1 <br />�/,� D/=. � S e rc/ic—F, � ' . <br />Eledtical COnlrador Mail Address <br />Slale License Number <br />�-^ I 1 <br />✓//i �;�� ! �/r"J'1. �F <br />Propos� Use of Building <br />_.. ''.',I; <br />Clly <br />`��i`_i-,1.� ; { �7'� <br />SCib,,Z4� Phone <br />� I.��.;i�� <br />Stale/Zip <br />Conlract Price of Work <br />Conlacl Person (Plan Review) <br />L J � �+ <br />Descriplion ot Work to Oe Done: �L�e �'Vi /"—� � ✓-'2 /,v� / ��{ �}"OC�in'1 <br />NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />�E IN RACEWAYS. MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certily thaf I heve read and exarnined fhis application and know fhe same lo be true .3nd <br />correcL All pro��isions ollaws and ordinances govemrng fhis f}�pe ol work will Ge comp/eted <br />�rhefher spealied herein or noL Th� granfing o/ a pemut does not resume fo _qive authorif}� fo <br />violafe or cancel the provisions olan}� olher stafe or local law reguPting consWction or fhe <br />pe�fomiance o/ conslnicfion. Thaf 1 am authonzeAby the oH�ner ol this property to perfonn Ihe <br />work Ior which application is made and 1 cornpty with fhe Sfafe Contractors Larv f8.27 RClNand <br />29G.200 WAC. � <br />/ <br />� �-�� ///i / <br />., ._, ; i _� � /`.�`.,ti_/I `� ' �:� ` Q � <br />� <br />.- ��Siynaluro " Date <br />fEE <br />Pl��cno <br />Phone <br />„� <br />')i 'i: <br />